Liver transplant candidates have a wide range of tasks and considerations to take care of after they have been referred for a possible transplant. From financial and emotional to physical considerations, knowing how to prepare for a liver transplant will help prepare you as the patient for the long road ahead.

Steps

Part 1

Preparing Mentally For the Transplant Operation

1

Undergo psychological testing. Before your transplant surgery is approved, your transplant team will make you undergo various psychological testing to make sure that you are mentally prepared to handle the upcoming surgery. This will help ensure that you have the support system you will need during recovery and that you understand the mental strain a transplant surgery can put on you.[1]

Psychological testing can include a psychological evaluation, talking with social workers to figure out who your pre- and post-surgery support system will be, as well as addiction counseling as necessary.

2

Prepare yourself for liver complications. As with any surgery, there is a chance for certain complications, including rejection or infection. Both can be surmountable, so put yourself into a mindset of healing and defeating any obstacle. A positive outlook will increase your chance of surviving the surgery and its aftercare.[2]

3

Get your support system in place. It is important that you have people in your life who you can count on during the surgery itself, but especially during the recovery. You can’t do everything yourself and you’ll need to take it easy so your body can heal itself.[3]

It would be best to have someone with you at all times during the recovery process, but if that’s not possible, you’ll need someone to come check on you and help you with things at least once a day.

You will need help for a few weeks with everyday things like grocery shopping and walking around.

If you don’t have anyone in your life that you can ask, you could look into hiring an in-home caregiver for your recovery period[4] or ask your pastor if any of the congregation members might be willing to help.

Part 2

Preparing Physically For the Transplant Operation

1

Pack a bag for the hospital. Prepare your bags for the hospital ahead of time, and have them ready at a moment's notice. The call for a new liver could come at any time and you’ll need to get to the hospital as soon as possible.[5]

Bring a couple changes of clothes, things to keep you occupied while you are in bed for several days (books, magazines, movies, knitting, etc.), and any other personal items you would not want to be without for an entire week.

Most patients stay in the hospital for at least one to two weeks after a liver transplant surgery.

2

Stay close to your phone or pager, and wait for the call or page. Transplant coordinators will generally ask also that while you are on the list that you stay no farther than a specified distance from the transplant hospital in order to ensure that you will be able to travel there with enough time for the donor liver to stay viable.

3

Follow pre-op orders regarding food and drink. Do not consume any food or drink anything if you have been called about a potential match. They are required to wait a certain amount of time (around 12 hours) after you last ingested something before they can put you under for surgery.[6]

This could potentially cause you to lose precious time while the new liver is still viable.

4

Shower the day of the surgery. It may be several days before you’re able to bathe again after the surgery, so you’ll want to make sure you shower before you head to the hospital. Cleaning your body will help make your more comfortable (especially in the days following the surgery) and help the pre-op team get your ready for surgery.

To prepare your body for surgery, you’ll also need to remove all external elements. For example, remove any nail polish, take off all of your jewelry, and wear your glasses instead of contact lenses.

5

Go to the hospital if they call you about a match. Check in at the hospital or transplant center as instructed by your coordinator. If there is a match for your liver, you’ll need to get to the hospital as soon as possible to be prepped for surgery.

When you check in, you’ll meet with your doctor (or another member of the transplant team) to discuss what will happen as you move forward in the procedure. They will explain the procedure to you and help guide your expectations about what will happen.

The team will help prepare you for the surgery – clean your body, put you in a hospital gown, and take you to the operating room when you are ready.

Part 3

Getting a New Liver

1

Get your liver function tested. Your doctor will refer you to a transplant specialist who will conduct the necessary tests to determine if you are a viable candidate to be put on the list. You will need to undergo various physical tests to determine the functionality of your existing liver.[7]

People with higher MELD scores are typically placed higher on the waiting list for a new liver.

3

Get on the national waiting list for organ donation. The first major step toward undergoing a liver transplant is being placed on the national waiting list by a transplant center team. Organ donation is managed in the United States by United Network for Organ Sharing (UNOS).[9]

While getting on the waiting list an important step toward getting your new liver, it does not guarantee that a match will be found.

4

Undergo financial counseling. Financial counseling will be included in your pre-transplant preparations to help you comprehend the expenses that you will be looking at from the surgery and after care, and to determine if and how much your insurance company can help you with that.[10]

It is important to understand how much of a financial strain this will put on your and your family so that there are no surprises later when you are recovering.

5

Wait to hear about your case. Once you are on the waiting list, there is not much you can do except wait for news. The transplant committee will convene to discuss if transplantation is the right course of treatment for you and they will keep you updated on any progress made in finding you a new liver.

6

Continue treatment as needed with your doctor as you wait for your new liver. You must continue living and treating your illness while you are on the waiting list to give yourself the best chance of survival. Follow any of your doctor’s orders and try to maintain overall good health while you wait.[11][12]

During this time you should be very conscientious about making healthy lifestyle choices – like eating well, exercising if possible, not smoking, not drinking, etc.

7

Find a live liver donor. If possible, ask your friends and family members to get tested to see if they are a potential match with you. This may increase your chances for getting a new liver more quickly. Speak to your transplant team if you have a family member willing to do a living liver transplant.[13]

Remember that there are significant risks for the donor, so try to be understanding if people are wary of doing this for you.

Once a liver is viable, it must be transplanted within 12-18 hours.[14]